Active NPI
George B Symonds
- Optometrist
- Port Angeles, WA
National Provider Identifier
1124028782
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OD00001757
- Practice address
- 1122 E Front St
Port Angeles, WA 98362-4308 - Phone
- (360) 457-1161
- Fax
- (360) 457-2806
- NPI assigned
- Jul 26, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OD00001757 | WA | Primary |
Addresses
Primary practice location
1122 E Front St
Port Angeles, WA 98362-4308
Mailing address
1122 E Front St
Port Angeles, WA 98362-4308
Phone (360) 457-1161
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2006096 | Medicaid | WA | |
| G000500197 | Other | WA | MEDICARE ID-PIN |
| 0D00001757 | Other | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100304000551 | WA | Practitioner - Optometry | 2466597273 | Practice locations: Port Angeles, WA |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Pacific University - College of Optometry, 1986
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1122 E Front St
Port Angeles, WA 98362-4308
Phone (360) 457-1161
Merit-based Incentive Payment System (MIPS)
- Final score
- 10.3 of 100
- Quality
- 20.61
- Improvement activities
- 0
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 15 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1124028782",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1122 E FRONT ST",
"city": "PORT ANGELES",
"state": "WA",
"postal_code": "983624308",
"telephone_number": "360-457-1161",
"fax_number": "360-457-2806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1122 E FRONT ST",
"city": "PORT ANGELES",
"state": "WA",
"postal_code": "983624308",
"telephone_number": "360-457-1161",
"fax_number": "360-457-2806"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SYMONDS",
"first_name": "GEORGE",
"middle_name": "B",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-07-26",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WA",
"license": "OD00001757",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2006096",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE ID-PIN",
"identifier": "G000500197",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WA",
"identifier": "0D00001757",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Port Angeles, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.